Ignition Interlock Removal Authorization

This form is for monitoring authorities to approve the removal of an Ignition Interlock Device (IID).

If you are a client, please click on Device Removal page to start the removal process of your IID.

The client below is authorized to have the IID removed as of the date noted:

"* (required)" indicates required fields

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This field is for validation purposes and should be left unchanged.

Client Name* (required)

State of Conviction* (required)

Date of Birth* (required)

Driver's License

Case Number* (required)

Removal Authorized On or After* (required)

Authorized By* (required)

Email* (required)

Phone* (required)

File Uploads

Please upload any official documentation that may be required to authorize the Ignition Interlock removal.

Drop files here or

Accepted file types: jpeg, jpg, png, pdf, doc, docx, xls, xlsx, Max. file size: 50 MB, Max. files: 5.

Additional Information

Authorization Approval* (required)

By clicking Submit, you are authorizing the removal/de-enrollment of the breath alcohol monitoring (Ignition Interlock) device for the person named herein.

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Ignition Interlock Removal Authorization

This form is for monitoring authorities to approve the removal of an Ignition Interlock Device (IID).

If you are a client, please click on Device Removal page to start the removal process of your IID.

The client below is authorized to have the IID removed as of the date noted:

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